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NUTR 315 > Bone Health (2/12) > Flashcards

Bone Health (2/12) Flashcards

1
Q

What are minerals?

A

inorganic elements needed in small amounts in the diet for normal function, growth and maintenance of body tissue

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2
Q

What are the major minerals?

A

calcium, phosphorus, magnesium, and sulfur

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3
Q

What are the major electrolytes?

A

sodium, potassium, chloride

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4
Q

What is a peak bone mass?

A

how much bone at the end of skeletal maturation

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5
Q

When is the spine peak bone mass?

A

20s

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6
Q

When is the hip peak bone mass?

A

teens

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7
Q

What does a 5% increase in bone mass result in?

A

40% reduction in fracture risk

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8
Q

When is 50% of peak bone mass acquired?

A

in adolescence

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9
Q

When is up to 90% of peak bone mass acquired?

A

by age 18 in girls and age 20 in boys (can keep growing by age 30)

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10
Q

What are different opportunities that can increase bone gain?

A

regular exercise, avoidance of: carbonated soft drinks, excessive alcohol and tobacco use

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11
Q

What does reduced peak bone mass result in?

A

reduced adult bone mass

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12
Q

What is osteoporosis?

A

calcium loss… especially in women after menopause or a hysterectomy (loose estrogen)

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13
Q

What is osteoporosis linked to?

A

low intakes of calcium that is crucial for maintaining bones but also for heart and muscle functions, blood clotting, transmission of nerve impulses, muscle contraction, cell metabolism

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14
Q

Where does the body withdraw calcium from?

A

from bone to maintain the level in the blood

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15
Q

How many people does osteoporosis affect?

A

more than 8 million women and 2 million men

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16
Q

What limits bone resorption (breakdown)?

A

estrogen by decreasing the activity of the osteoclasts

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17
Q

What are risk factors for osteoporosis?

A

gender, age, race, body size, genetics, disease, drugs, alcohol, caffeine, smoking, exercise, emotional stress, reproductive status, and diet (+/-)

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18
Q

How is gender a risk factor for osteoporosis?

A

women over 50 at the highest risk because of decreasing levels of estrogen, thinner bones, and longer lifespan

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19
Q

How is age a risk factor for osteoporosis?

A

bone mass begins to naturally decline after max bone mass is reached (around age 30)

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20
Q

How is race a risk factor for osteoporosis?

A

caucasian and asian at higher risk; african americans at lowest risk followed by those of hispanic/latino heritage

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21
Q

How is body size a risk factor for osteoporosis?

A

small and thin women at higher risk

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22
Q

How is genetics a risk factor for osteoporosis?

A

family history increases the risk

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23
Q

How is disease a risk factor for osteoporosis?

A

impaired absorption, metabolism and utilization of bone-forming nutrients, or increased nutrients excretion

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24
Q

What drugs are a risk factor for osteoporosis?

A

chronic use of glucocorticoids and proton pump inhibitors

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25
Q

What are modifiable factors that increase the risk of osteoporosis?

A

high alcohol consumption, high caffeine consumption, smoking, lack of exercise, emotional stress, reproductive status, and diet

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26
Q

What is characteristics of osteoporosis?

A

wedged upper vertebrae and crushed lower vertebrae

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27
Q

What is rickets?

A

softening and weakening of bones in children usually because of extreme and prolonged vitamin D deficiency or the vit D deficiency combined with calcium deficiency

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28
Q

What does vitamin D promote?

A

absorption of calcium and phosphorus from the gastrointestinal tract

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29
Q

What are symptoms of rickets?

A

delayed growth; pain in spine, pelvis, legs; muscle weakness; and skeletal deformation (bowed legs, thickened wrists & ankles, breastbone projection)

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30
Q

What is osteomalacia?

A

prolonged calcium deficiency resulting in slow removal of calcium from bones

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31
Q

What is another term for osteomalacia?

A

“adult rickets”

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32
Q

What is osteomalacia often linked to?

A

vitamin D deficiency

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33
Q

What are the nutrients involved in bone health?

A

calcium, vitamin D, and phosphorus

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34
Q

What is bone remodeling?

A

bone that is continually being build, broken down and reshaped (throughout adulthood)

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35
Q

T/F: bone remodeling is occurring all the time

A

true

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36
Q

Where is calcium found?

A

99% in bones and teeth and 1% in the blood stream

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37
Q

What is bone?

A

collagen + ground substance + calcification

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38
Q

What is calcium for?

A

growth and a cofactor with many functions (cell membrane structure, cell adhesion, collagen, nerve impulse conduction, muscle contraction, blood clotting, and enzymes

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39
Q

Where is calcium absorbed?

A

along the length of the intestinal tract, the most efficient in the upper part of the small intestine (slightly acidic pH helps keep calcium dissolved in its ionic form, ca)

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40
Q

How much of calcium does adults absorb?

A

10-60%

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41
Q

How much of calcium does children absorb?

A

75%

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42
Q

How is calcium absorbed?

A

active transport (upper parts of the intestine, regulated and promoted by vitamin D) and passive diffusion (lower parts of the intestine)

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43
Q

What is calcium absorption influenced by?

A

amount of Ca in diet, need for Ca, vitamin D, decline with age, lactose rich foods increase absorption, protein increases absorption, phosphorus in the diet decreases absorption, plant components decrease absorption, caffeine (not in complete agreement), drugs containing antacids decrease absorptions, GI high motility decreases absorption, and emotional instability decreases absorption

44
Q

What is the main location of regulation of balance of calcium?

A

absorption

45
Q

How is calcium excreted?

A

in the kidney and feces

46
Q

What happens when there is a decrease in blood calcium?

A

increase in PTH which causes increased resorption in the bone, increased absorption in the intestine, increased activation of vit D which leads to increased calbindin which leads to increased reabsorption in the kidney.

47
Q

What is the normal range for blood calcium?

A

8.5 mg/dl - 10.8 mg/dl

48
Q

What happens if someone has low blood calcium?

A

parathyroid gland releases parathyroid hormone which then stimulates calcium release from bones to increase blood calcium, the increased calcium uptake in intestines increases blood calcium, and increases calcium retention in kidneys to increase blood calcium. the blood calcium is returned back to a normal range

49
Q

What happens if someone has elevated blood calcium?

A

Thyroid gland releases calcitonin which reduces calcium release from the bones and reduces calcium retention in kidneys. This brings blood calcium to a normal range

50
Q

If a dietary calcium intake is 1000 mg how much of it is absorbed?

A

300 mg (1/3)

51
Q

What is the RDA for calcium?

A

1000 mg/d

52
Q

What is the RDA for calcium in pregnancy/lactation?

A

1300 mg/d

53
Q

What is the UL for calcium?

A

2500 mg/d

54
Q

how do we increase the absorption of calcium?

A

by having repeated doses

55
Q

What is hypercalcemia?

A

ca rigor

56
Q

What is ca rigor?

A

constant state of muscle contraction

57
Q

What is hypocalcemia?

A

tetany

58
Q

What is tetany?

A

increased excitability (continuous forceful muscle contraction without relaxation; neuromuscular irritability, seizures)

59
Q

Where is phosphorus found?

A

80% in bones and teeth

60
Q

What does phosphorus combine with to form hydroxyapatite?

A

calcium

61
Q

T/F: phosphorus is required by every cell, important in almost every reaction as a component of ATP

A

true

62
Q

What helps release phosphorus from foods?

A

phosphatase

63
Q

How is phosphorus absorbed?

A

with assistance from vit D mainly in the upper part of the small intestine

64
Q

Why kind of absorption happens with phosphorus?

A

active transport or passive diffusion

65
Q

What controls absorption, excretion, and bone resorption of phosphorus?

A

PTH (parathyroid hormone)

66
Q

What is the main regulator of phosphorus balance in blood?

A

excretion

67
Q

What percent of dietary phosphorus do adults absorb?

A

up to 70%

68
Q

Where is phosphorus present?

A

in grains and legumes in the form of phytates (poorly absorbed) and grain products with yeast

69
Q

What does yeast do to phytates?

A

break them down

70
Q

What is the RDA of phosphorus for adults?

A

700 mg/d

71
Q

What is the UL of phosphorus?

A

4 g/d

72
Q

What are the richest sources of phosphorus?

A

protein-rich foods (meat, poultry, fish, eggs), carbonated beverages

73
Q

What is the average intake of phosphorus/

A

1500 mg/d for men and 1000 mg/d for women

74
Q

What happens to cattle on low phosphorus soil?

A

exhibit changes in appetite, emaciation (thin and weak), weakness

75
Q

When does phosphorus deficiency occur in humans?

A

with excess use of antacids or excess urine production, or in premature infants, or in alcoholics and cases of long-term diarrhea and weight loss

76
Q

What are symptoms of phosphorus deficiency?

A

insufficient bone mineralization, weight loss, weakness, bone pain

77
Q

T/F: phosphorus deficiency is common in the human population

A

FALSE! very rare

78
Q

What is ergocalciferol?

A

the form of vitamin D that is naturally found in foods

79
Q

What is cholecalciferol?

A

vitamin D formed in human body from dehydrocholesterol upon sunlight exposure

80
Q

how much of vitamin D does sun exposure provide?

A

up to 80-100%

81
Q

How much does production of vitamin D in the skin decrease by when one reaches the age of 70

A

70%

82
Q

What is the RDA for vitamin D?

A

600 IU/d for men and women

83
Q

What is the UL for vitamin D?

A

4000 IU/d

84
Q

What are food sources of vitamin D?

A

egg yolk, butter, fish oils, organ meats and fortified milk

85
Q

What is the amount of IU in 1 microgram of calciferol?

A

40 IU

86
Q

what does IU stand for?

A

international unit

87
Q

What is the OD for vit D?

A

100,000 IU/d; infants 4-5x RDA

88
Q

What are the functions of magnesium?

A

50% in bones, enzyme activator, muscle contraction, temperature regulation, PTH release & activation of vit. D

89
Q

Where is magnesium absorbed?

A

in the small intestine by a specific carrier (35-40%)

90
Q

What reduces the efficiency of absorption of magnesium?

A

reduced by Ca, alcohol, phosphate, phytates, and fat

91
Q

What happens if there is decreased plasma magnesium?

A

PTH release which increases absorption of magnesium and activation of vitamin D

92
Q

What is the main regulator of balance (regulation of excretion by reabsorption) for magnesium?

A

kidney

93
Q

What increases magnesium losses?

A

increased urine production (diuretics, alcohol)

94
Q

What is the RDA for magnesium?

A

400 mg/d for men & pregnant women and 310 mg/d for women

95
Q

What is the UL for magnesium?

A

350 mg/d (pharm only, refers to supplements and non-food sources)

96
Q

What are sources of magnesium?

A

green leafy veggies, legumes, seafood, nuts, cereals, dairy products

97
Q

What causes losses of magnesium from the foods?

A

cooking and processing of grains

98
Q

What causes magnesium deficiency?

A

as a result of reduced absorption and/or increased excretion (increased urine production) for a prolonged period of time

99
Q

What happens if you have low blood levels of magnesium?

A

low magnesium tetany

100
Q

What are symptoms of magnesium deficiency?

A

increased calcification of soft tissues and kidney stones

101
Q

What is sulfur primarily provided by?

A

sulfur-containing amino acids found in hair, nails, and skin

102
Q

What are the three vitamins that you can get sulfur from?

A

thiamin, biotin, and pantothenic acid

103
Q

What is sulfur good for?

A

stabilization of protein structure and regulation of acid-base balance

104
Q

What is the RDA for sulfur?

A

no RDA… amount in diet related to sulfur-containing amino acids in diet

105
Q

What diet may have reduced levels of sulfur?

A

vegetarian diets since many plants (especially grains) have reduced levels of S-containing amino acids

NUTR 315 (22 decks)

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